Elite Fitness and Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ELITE FITNESS AND PHYSICAL THERAPY PLLC

Practice address

2300 E Las Olas Blvd
Fort Lauderdale, FL 33301-1598

Phone

(423) 737-3363

NPI assigned

Dec 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tarra Wardrup Stetson, DPT, CSCS

Title

Sole Member

Phone

(423) 737-3363

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1124666144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011598",
            "telephone_number": "423-737-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333011598",
            "telephone_number": "423-737-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE FITNESS AND PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "WARDRUP STETSON",
        "authorized_official_first_name": "TARRA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "423-737-3363",
        "authorized_official_credential": "DPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.